Corticosteroid use in neurology: how dogs are referrals to a neurology service?

Abstract

Corticosteroids are drugs widely used in veterinary neurology due to their recognized anti-inflammatory, immunosuppressive and analgesic effects. However, their use in high doses and for long term may result in undesirable side effects. This study describes the prevalence of dogs with neurologic diseases referred to a veterinary neurology service with previous prescriptions for corticosteroids. In this retrospective study 284 medical records of dogs were evaluated in the period between August 2017 and April 2019. Of these, 194 (68%) dogs had already received medical care from a clinician and 100 (52%) had previously been prescribed corticosteroids. After diagnosis at the reference service, the corticosteroid dose was suspended in 28% of the cases, adjusted in 41% and maintained in 31%. Dogs receiving immunosuppressive doses were the most affected and in 71% and 21% of the cases, their medication was adjusted or suspended, respectively. In conclusion, the therapy for neurological diseases is still strongly associated with the indiscriminate use of corticosteroids, without the dosage correlated to the desired effect.

Steroid‐responsive meningitis‐arteritis secondary to septic arthritis due to Pasteurella multocida in a bull terrier puppy

“…In this report, despite clear evidence pointing to an acute SRMA, we chose not to administer immunosuppressive dose of corticosteroids before the results of infectious disease serologies and bacterial culture were available. Dexamethasone at 0.15 mg/kg/24 hours IV has been described in human medicine for the treatment of bacterial diseases of the CNS to decrease intracranial pressure, decrease CNS inflammation and lower the risk of neurologic sequelae 25 . In small animals, immunosuppression is generally accomplished with prednisolone at 2.2−6.6 mg/kg/24 hours or the equipotent dosage of dexamethasone at 0.33−1.1 mg/kg/24 hours 26 .…”

“…Dexamethasone at 0.15 mg/kg/24 hours IV has been described in human medicine for the treatment of bacterial diseases of the CNS to decrease intracranial pressure, decrease CNS inflammation and lower the risk of neurologic sequelae. 25 In small animals, immunosuppression is generally accomplished with prednisolone at 2.2−6.6 mg/kg/24 hours or the equipotent dosage of dexamethasone at 0.33−1.1 mg/kg/24 hours. 26 The clinical deterioration 12 hours after treatment induction was, therefore, considered to be related to the progression of the septic arthritis, rather than induced by corticosteroid administration.…”